04D2265016 CLIA NUMBER - SPA CITY PAIN MANAGEMENT CLINIC

Laboratory Demographics

  • CLIA Code: 04D2265016
  • Facility Name: SPA CITY PAIN MANAGEMENT CLINIC
  • Facility Address: 117 PIPER STREET, SUITE L
    HOT SPRINGS, AR
    ZIP 71901
  • Facility Phone: 501 651-0018
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DONALD CRABTREE
  • NPI Number: 1043971096
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2265016
LAB Type Physician Office
Facility Name SPA CITY PAIN MANAGEMENT CLINIC
Street 117 PIPER STREET, SUITE L
City HOT SPRINGS
State AR
ZIP 71901
Phone 501 651-0018
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director DR. DONALD CRABTREE

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This page was last updated on: 9/29/2025